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lie �" CERTIFICATE OF LIABILITY INSURANCE F7/31/2014
<br />1 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW.. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER,
<br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the Policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder In lieu of such endorsement(s).
<br />PRODUCER REACT Paula Papa
<br />Insurance Solutions
<br />,��.^ Q949y 348 -7400 I$ra9l9aa -2373
<br />License #0746539 I. Pau1aP @ins- salutans,aam
<br />33302 Valle Rd, Suite 200 INS�r�r�s�FOr :caoNOCOwERpIaIa Na�c�
<br />Ca 92675 _ ,InsURERA:Sentknel Ina Cow, LTCI 1I000
<br />San 0"uarCapistrano CA,..._. - �_.�__® ..._..... ........_ __._
<br />INSURED INSURERa.,Twin Cat Fire Ins Co 29458
<br />PELLETIER & ASSOCIATES INC INSURERCMount Vernon Fire w_ Ins Cont�aany 26522
<br />PO BOAC 388'
<br />Lt�� FOi'ST CA. �26�'� INSURERF:
<br />COVERAGES CERTIFICATE NUMBER:14 -15 REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. N07WTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />µ TIO OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
<br />INSrRCLUSIO NS AND CONDITIONS
<br />1.1ft TYPEOFINSURANCE .. W AUK
<br />IM WVD PaLicYNUM ER PCILpCY I, L .,.Poch UP � LBNIrT$ ... ._-- ....__w_....__...._..,.....
<br />GENERAL LIABILITY
<br />EACH OCCURRENCE $ 1 , 000 , 400
<br />X COMMERCIAL GENERAL LIABILITY MAGE T5W9ffl=...-
<br />PREMISES,;,(Ea �rron 1 It 1,000,000
<br />A CLAIMS —MATW OCCUR 2SBAIT7595 B/1 {2014 8/1/2015 MEDEXP(Ah arla0allpn@ $ 10,000
<br />PERSONAL a ADV INJUr:Y S 1,000,000
<br />— GENERALAGGREGATE- � $ 2,000,000
<br />GEN'LACEiREGr1rE LIMIT AMILIES..PER.: . PRODUCTS- COMPIOPAGG S 2,00'0',000 QT F POLICY Jf:' Q LC�CC S
<br />AUTOMOBILE LIABILITY COMBINED SINGLE LIMP
<br />ANY AUTO BODILY INJURY Y (Perperson) - ..w.,,,. _..
<br />ALL OWNED SCHEDULED 72SBAIT7595 8/1/2014 /1/2015 -_. _..
<br />AUTOS �,M AUTOS BODILY INJURY (Per aeddent) $
<br />X HIRED AUTOS X AUTOS PRC3PERTY I5€UAaGE�
<br />UMBRELLA LIAR OCCUR
<br />EACH OCCURRENCE S
<br />EXCESS LIAa CLAIMS MADE AGGRFC.a'ATE �.�.._.__m...........$ .. ....d_....., „W�.„,,,.,,„.,.,...
<br />DED RETENTION S $
<br />B WORKERS COMPENSATION Y LlI'�41UC OTH
<br />AND EMPLOYERS' LIABILITY YIN
<br />ANY PROPRIETORIPARTNER/EXECUTIVE E.L EACH ACCIDENT S W 1 000„x.0u00.
<br />OFFICERNEMBER EXCLUDED? NIA
<br />(MarefatorlllnNMI 72WECLP3277 8/1/2014 /1/2015 �E.L.DISEASE- EAEMPLOYEF S 1 000 000
<br />..___ ..
<br />If yas, daecdba under .r- ..._w.m®r _..„
<br />DESORIPTIDNpF OPERATI ,3NSLalaw _ w .w E,L,DISEASE - POLICY LIMIT S 1 0004000
<br />C Errors & Omissions P2009690E 8/1/2014 9,/1/2015 I- ImIt:$2 „000,7£Io
<br />Deductible: $ 1,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS t VEHICLES (Attach ACORD 101, AddlLlonal Remarks Schedule, W more apace Is ragairadl
<br />City of Santa .Anna, 20 Civic Center Plaza, California 92701, its officers, amt acs, agents, volunteers
<br />and representatives are named as additional insured per the Business Liab � s v
<br />attached to the policy. Coverage is Primary per attached. endorsement.
<br />, A
<br />� w Jose h Straka
<br />CERTIFICATE HOLDER
<br />CANCELLATION ....
<br />IBMoral ss5 @ s a.nta -ana , org SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />City of S'ant;a Ana ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Attn: Risk Management, M28
<br />20 Civic Center Plaza AUTHORIZED REPRESENTATIVE
<br />Santa Ana, CA 92702
<br />T Alessandra /PETERS
<br />ACORD 25 (20401055) C 1986 -2010 ACORD CORPORATION, All rights reserved.
<br />INS02 5 orrInAm m T°ho Ar nPn nnnna and Inrrn arcs raml+allcanarl market of di„C'I$wn
<br />
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